I’m president of the Galen Institute, a non-profit research organization that focuses on market-driven health policy, and a co-author of Why ObamaCare Is Wrong for America (Broadside/HarperCollins, 2011)

Obamacare's Manifold Errors Force Major Changes In The Failed Law

President Obama is making yet another illegal change to his health law, continuing a long pattern of trying to fix his fatally flawed signature legislation by administrative fiat.

By our count, more than 27 significant changes already have been made to ObamaCare, including at least 10 the administration has made and 15 passed by Congress and which the president signed into law. But even this large number of changes hasn’t stopped the cascade of failures we are seeing today.

Mr. Obama’s latest effort won’t work either in his effort to stop people from losing health insurance because of his law. Even worse, he is scapegoating the industry he most needs to make the law work — health insurers — to stem his own political pain.

He issued his administrative order Thursday allowing some people who had some plans in effect on October 1 to keep them under some circumstances. But his move was at least partly to get ahead of measures that are gaining bi-partisan support in Congress to help the millions of people who are losing their health insurance.

The Keep Your Health Plan Act, sponsored by Energy and Commerce Committee Chairman Fred Upton, R-MI, will be considered in the House Friday (Nov. 15). A companion measure is being offered in the Senate by Sen. Ron Johnson, R-WI. Sen. Mary Landrieu, D-LA, is offering the Keeping the Affordable Care Act Promise Act, which takes a different approach but has a similar goal.

“Implementation of this law has been disastrous, leaving worried Americans without the health care plans they had, skyrocketing premiums, and limited access to doctors,” Chairman Upton said. “As we vote on the Keep Your Health Plan Act, we call on the president to work with Congress, not around us.”

Some who have been vigilant in helping the American people see ObamaCare’s manifold failures are opposing the House measure, worrying about making “a fix” to this fatally flawed law. But the Keep Your Plan Act will not alter the corrupting core of ObamaCare.

It is incumbent on public servants, whatever their political affiliation, to protect people from clear harm whenever they can.

The HealthCare.gov website is unlikely to be fixed by the end of November. The Upton bill being considered by the House is a first step to try to stem the tide of cancellations that have been occurring, and which will continue to occur, as a result of ObamaCare. Upton will not “fix” the law in any way, but it could give some people a chance to keep coverage they might otherwise have lost. And it uses the legal process of changing the law through congressional action to do so.

ObamaCare must go, but in the meantime, the American people’s elected representatives need to protect them as much as possible from harm. The 27 “fixes” that already have been made to the law have not made it better but have indeed protected some Americans from even further damage, such as protecting small business from the 1099 paperwork mandate.

Here is the list of changes that have already been made to the law. It shows those made by the Obama administration; changes made by the 111th Congress (under Democratic control of the House) and signed by President Obama; changes made by the 112th and 113th Congresses (under Republican control of the House) and signed by the president; and those made by the U.S. Supreme Court.

Changes to the health law by administrative action before today’s one-year reprieve for private health plans:

Congressional opt-out. The administration gave Members of Congress and their staffs the option of exempting themselves from the ObamaCare exchanges created by the ACA, contrary to the language in the law. ( September 30, 2013)

Exchange enrollment: The administration extended by six weeks – from February 14 to March 31, 2014 – the period in which people can enroll for coverage and avoid the individual mandate tax penalty. (October 23, 2013)

Employer mandate delay: By an administrative action that also is contrary to statutory language in the ACA, the reporting requirements for employers were delayed by one year. (July 2, 2013)

Self-attestation: Because of the difficulty of verifying income after the employer reporting requirement was delayed, the administration decided it would allow “self-attestation” of income by applicants for health insurance in the exchanges. (This was later partially retracted after congressional and public outcry over the likelihood of fraud.) (July 15, 2013)

Small businesses on hold: The administration said that the federal exchanges for small businesses would not be ready by the 2014 statutory deadline. Instead, officials delayed until 2015 implementation of federal SHOP exchanges for small businesses. (March 11, 2013)

Close high-risk pool: The administration decided to halt enrollment in federal high-risk pools, blocking coverage for an estimated 40,000 new applicants, and decided, rather than using money from a fund under HHS Secretary Sebelius’ control to extend coverage for Americans with pre-existing conditions, to instead use the money to pay for advertising for ObamaCare enrollment. (February 15, 2013)

Medicare Advantage patch: The administration ordered an advance draw on funds from a Medicare bonus program in order to provide extra payments to Medicare Advantage plans to temporarily forestall cuts in benefits and therefore delay exodus of MA plans from the program. (April 19, 2011)

Reports for employee: The administration, contrary to the legislation, instituted adelay by one year in the requirement that employers must report to their employees on their W-2 forms the full cost of their employer-provided health insurance. (January 1, 2012)

Doubling allowed deductibles: Because some group health plans use more than one benefits administrator, plans are allowed to apply separate patient cost-sharing limits to different services, such as doctor/hospital and prescription drugs on group health plans. (February 20, 2013)

Low-income basic plan delayed: The administration delayed implementing the Basic Health Program until 2015. It would have provided more affordable health coverage for certain low-income individuals not eligible for Medicaid. (March 22, 2013)

Changes to the health law by Congress and signed into law by President Obama:

1099 repealed: Congress repealed the paperwork (“1099”) mandate that would have required businesses to report to the IRS all of their transactions with vendors totaling $600 or more in a year. (April 14, 2011)

CLASS out: Congress repealed the unsustainable CLASS (Community Living Assistance Services and Supports) long-term care government “insurance” program which even the Democratic chairman of the Senate Finance Committee dubbed a “Ponzi scheme of the first order.” (January 2, 2013)

Cut Co-ops: Congress cut $2.2 billion from the “Consumer Operated and Oriented Plan” (CO-OP) program, which had been called a “stealth public plan,” blocking creation of co-ops in about half the states after early reports showed many co-ops were very troubled financially. (January 2, 2013)

No free-choice vouchers: Congress repealed a program, supported by Oregon Sen. Ron Wyden, D, that would have allowed “Free Choice Vouchers,” which The Hill warned “could lead young, healthy workers to opt out” of their employer plans, “driving up costs for everybody else.” The same law barred additional funds for the IRS to hire new agents to enforce the health care law. (April 15, 2011)

No Medicaid for rich seniors: Congress saved taxpayers $13 billion by changing how the eligibility for certain programs is calculated under ObamaCare. Without the change, a couple earning as much as much as $64,000 would still have been able to qualify for Medicaid. (November 21, 2011)

CO-OPs, IPAB, IRS: Congress made further cuts to agencies implementing ObamaCare. It trimmed another $400 million off the CO-OP program; cut another $305 million from the IRS to hamper its ability to enforce the law’s tax hikes and mandates; and rescinded $10 million in funding for the controversial Independent Payment Advisory Board. (December 23, 2011)

More Louisiana cash: One of the tricks used to get ObamaCare through the Senate was the special Louisiana Purchase deal for Sen. Mary Landrieu, D-LA. Congress saved another $670 million by rescinding additional funds that gave a special deal to her home state. (July 6, 2012)

Medicare trust transfer: Congress rescinded $200 million of the $500 million transfer from the Medicare Part A and Part B trust funds for the Community-Based Care Transition Program established and funded by ACA. (March 26, 2013)

Drug clarification: Congress modified the definition of average manufacturer price (AMP) to include inhalation, infusion, implanted, or injectable drugs that are not generally dispensed through a retail community pharmacy. (August 10, 2010)

Doc Tax Fix: Congress modified the amount of excess premium tax credits that individuals would have to repay to help offset the costs of the postponement of cuts in Medicare physician payments called for in the ACA. (December 15, 2010)

Adult children: TRICARE coverage was extended to dependent adult children up to age 26. (January 7, 2011)

Changes to the health law by the U.S. Supreme Court:

In its landmark decision challenging the ACA’s individual mandate and other provisions, the U.S. Supreme Court modified by judicial edict two key provisions of the law:

Medicare expansion voluntary: The court made it voluntary rather than mandatory for states to expand Medicaid eligibility to people with incomes up to 138% of the federal poverty level.

Individual mandate is a tax: The court determined that the mandate that Americans must purchase government-approved health insurance could be avoided if individuals choose instead to pay the penalty “tax,” making it optional for people to either comply or pay the tax.

Clearly, this law is being dismantled even before it takes full effect because it is so fatally flawed. For House Democratic Leader Nancy Pelosi to continue to mock House Republicans for their efforts to repeal and dismantle the law flies in the face of the facts when you see how much of the law already has been changed.

Tyler Hartsfield, Policy Analyst, assisted in the research for this list.

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